Search

Introduction: The COVID-19 pandemic, caused by SARS-CoV-2, causes everything from asymptomatic infections to severe acute respiratory syndrome, which can sometimes be fatal, requiring coping. Objective: To analyze the epidemiology of COVID-19 in the six mesoregions of the state of Pará, correlating it with the Average Human Development Index (HDIm) and the percentage of sewage treatment in the state. Methods: This is a cross-sectional descriptive study with a quantitative approach, carried out by collecting secondary data from the cases of COVID-19, collected from March 7 to May 30, 2020, and socio-demographic data from the six mesoregions. of the state of Pará. Results: 267,700 confirmed cases of COVID-19 were reported throughout the state of Pará. The mesoregions of the Southeast of Pará and the Metropolitan Region of Belém, presented the highest values, with 81,556 and 71,117, respectively. There was no difference in the number of cases between genders, however the two age groups most affected by the infection are between 30 and 39 years old (64,138 cases) and 40 to 49 years old (51,535 cases). Among the most prevalent comorbidities are Heart Diseases and Diabetes. Conclusion: The highest incidence rates of COVID-19 are concentrated in mesoregions with a large flow of people, with a tendency for sociodemographic aspects to be related to the epidemiology of COVID-19 in mesoregions of the state of Pará. Introducción: La pandemia de COVID-19, causada por el SARS-CoV-2, causa de todo, desde infecciones asintomáticas hasta síndrome respiratorio agudo severo, que a veces puede ser fatal y requiere afrontamiento. Objetivo: Analizar la epidemiología del COVID-19 en las seis mesorregiones del estado de Pará, correlacionándolo con el Índice de Desarrollo Humano Promedio (IDH) y el porcentaje de tratamiento de aguas residuales en el estado. Métodos: Se trata de un estudio descriptivo transversal con enfoque cuantitativo, realizado mediante la recolección de datos secundarios de los casos de COVID-19, recolectados del 7 de marzo al 30 de mayo de 2020, y datos sociodemográficos de las seis mesorregiones. De el estado de Pará. Resultados: se notificaron 267.700 casos confirmados de COVID-19 en todo el estado de Pará, siendo las mesorregiones del Sureste de Pará y la Región Metropolitana de Belém las que presentaron los valores más altos, con 81.556 y 71.117, respectivamente. No hubo diferencia en el número de casos entre sexos, sin embargo, los dos grupos de edad más afectados por la infección son entre 30 y 39 años (64,138 casos) y 40 a 49 años (51,535 casos). Entre las comorbilidades más prevalentes se encuentran las enfermedades cardíacas y la diabetes. Conclusión: Las mayores tasas de incidencia de COVID-19 se concentran en mesorregiones con gran flujo de personas, con tendencia a que los aspectos sociodemográficos estén relacionados con la epidemiología de COVID-19 en mesorregiones del estado de Pará. Introdução: A pandemia do COVID-19, ocasionada pelo SARS-CoV-2, provoca desde infecções assintomáticas até a síndrome respiratória aguda grave, que por vezes, pode ser fatal, necessitando de enfrentamento. Objetivo: Analisar a epidemiologia da COVID-19 nas seis mesorregiões do estado do Pará, correlacionando-a com Índice de Desenvolvimento Humano Médio (IDHm) e o Percentual de Tratamento de esgoto do Estado. Métodos: Trata-se de um estudo descritivo transversal com abordagem quantitativa, realizado através do levantamento de dados secundários dos casos de COVID-19, coletados no período de 07 de março a 30 de maio de 2020, e dados sócio-demográficos das seis mesorregiões do estado do Pará. Resultados: Foram notificados 267.700 casos confirmados da COVID-19 em todo o estado do Pará. As mesorregiões do Sudeste paraense e da Região Metropolitana de Belém, apresentaram os maiores valores, com 81.556 e 71.117, respectivamente. Não houve diferença de número de casos entre os gêneros, porém as duas faixas etárias mais acometidas pela infecção estão entre 30 a 39 anos (64.138 casos) e 40 a 49 anos (51.535 casos). Dentre as comorbidades mais prevalentes estão as Cardiopatias e o Diabetes. Conclusão: As maiores taxas de incidência da COVID-19 estão concentradas nas mesorregiões com grande fluxo de pessoas, havendo uma tendência dos aspectos sociodemográficos se relacionarem com a epidemiologia da COVID-19 nas mesorregiões do estado do Pará.

Objective: To systematically establish whether there is an association between polymorphisms and avascular necrosis in patients with sickle cell disease. Data source: The review, conducted according to PRISMA guidelines and registered with PROSPERO, was based on research of studies in PubMed, SciELO, LILACS, BVS databases and in the gray literature (Google Scholar and Open Gray) published until June 2020. The STROBE initiative was used to analyze the articles’ quality. Data synthesis: Ten articles were selected from the databases and two were included through manual search, totaling 12 studies. All samples gathered 2,362 patients. According to STROBE, seven studies fully and/or partially covered more than 70% of the essential items and two studies reached less than 60%, with an overall variation of 86.4–54.5%. The results indicate that polymorphisms in the genes of the bone morphogenetic protein 6 (BMP6), Klotho (KL) and Annexin A2 (ANXA2) may be associated with osteonecrosis in the context of sickle cell disease. Six articles addressed the polymorphism in the MTHFR enzyme gene, but only one found a positive association. Polymorphisms associated with the DARC receptor, the ITGA4 gene, CD36 and thrombophilia protein genes were not associated in any of the studies. Conclusions: The results indicate that the polymorphisms in BMP6, Klotho and ANXA2 genes may be associated with avascular necrosis in patients with sickle cell disease. However, in order to confirm these genetic changes as risk factors, further studies with greater statistical power and methodological rigor are needed. Resumo Objetivo: Estabelecer, de modo sistemático, se existe associação entre polimorfismos e a necrose avascular em pacientes com doença falciforme. Fontes de dados: A revisão, conduzida segundo as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e registrada no International Prospective Register of Systematic Reviews (PROSPERO), foi baseada na busca de estudos nas bases de dados PubMed, Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Biblioteca Virtual em Saúde (BVS) e na literatura cinza (Google Scholar e Open Gray) até junho de 2020. A análise da qualidade dos artigos foi baseada nos critérios do Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Síntese dos dados: Dez artigos foram selecionados nas bases de dados e dois incluídos por meio da busca manual, totalizando 12 estudos elencados. As amostras resultaram em 2.362 pacientes incluídos. Com base na iniciativa STROBE, sete estudos atenderam total e/ou parcialmente mais de 70% dos itens essenciais e dois atingiram menos que 60% deles, com variação geral de 86,4–54,5%. Os resultados mostram que os polimorfismos nos genes da proteína morfogenética óssea 6 (BMP6), da Klotho (KL) e da Anexina A2 (ANXA2) podem ter associação com osteonecrose no contexto da doença falciforme. Seis artigos estudaram o polimorfismo no gene da enzima MTHFR, mas apenas um obteve associação positiva. Os polimorfismos associados ao receptor DARC, ao gene ITGA4, ao CD36 e aos genes de proteínas trombofílicas não demonstraram associação em nenhum dos estudos. Conclusões: Os polimorfismos nos genes BMP6, KL e ANXA2 estão possivelmente associados com a necrose avascular em indivíduos com doença falciforme. Entretanto, para a confirmação dessas alterações genéticas como fatores de risco, é necessário que mais estudos com maior poder estatístico e com maior rigor metodológico sejam realizados.

Orientador(a): Prof(a). Dr(a). Regimeire Oliveira Maciel Dissertação (mestrado) - Universidade Federal do ABC, Programa de Pós Graduação em ECONOMIA POLÍTICA MUNDIAL. São Bernardo do Campo, 2021 Esta dissertação analisou a questão racial no Instituto Nacional de Ciência e Tecnologia de Inclusão do Ensino e na Pesquisa (INCTI) por meio do Projeto Encontro de Saberes (PES), realizado entre os anos de 2010 e 2013. De modo específico, discutiu-se como se deu o estabelecimento de diálogos epistemológicos entre conhecimento científico e os chamados saberes tradicionais afro-brasileiro (s). A hipótese provisória era de que as práticas de ciência e tecnologia, no contexto investigado, foram atravessadas pelo racismo estrutural que tem entre suas expressões o racismo epistêmico, materializado pelo apagamento, invisibilidade e silenciamento de saberes não eurocentrados. As referências teóricas centrais desta pesquisa estão alinhadas às perspectivas epistemológicas do sul global. Para tanto, foram fundamentais as contribuições de autores decoloniais como Ramón Grosfoguel (2008, 2009, 2011, 2020); Costa; Grosfoguel (2016) e Boaventura Santos (2000, 2008). Do ponto de vista dos instrumentos metodológicos, esta pesquisa teve uma abordagem qualitativa e foi realizada por meio de levantamento bibliográfico e documental. Na pesquisa bibliográfica, o levantamento documental foram realizados em materiais disponibilizados no site do Ministério da Ciência e Tecnologia, do Conselho Nacional Científico e Tecnológico ¿ CNPq e do Instituto Nacional de Ciência e Tecnologia de Inclusão no Ensino e na Pesquisa (INCTI)1 . Como resultado, esta pesquisa constatou, entre outros aspectos, que: a) a constituição de um instituto, como o INCTI, voltado para ciência e tecnologia foi importante política, epistemológica e metodologicamente para se conseguir conectar inclusão, ciência, tecnologias, ensino e pesquisa com relações raciais; b) houve, na ação investigada, construção de práticas de CT&I a partir de estratégias contrahegemônicas, ou seja, como processos construídos na luta, em que grupos sociais oprimidos se apropriam de filosofias e práticas, como as leis, o direito internacional etc., ressignificando-os, reconfigurando-as, subvertendo-as e transformando-as em ferramentas contra a dominação; c) houve resistência de parte da comunidade científica diante da criação de um instituto voltado para ciência, pesquisa e ensino, que vincularia sua identidade à questão étnico-racial; d) as práticas identificadas não foram 1 Em janeiro de 2019, por meio de uma reforma administrativa, no governo do então presidente Michel Temer, o MCTI passa a se chamar Ministério da Ciência, Tecnologia, Inovações e Comunicações. 13 capazes de romper o silêncio quanto à construção de diálogos dos saberes afro-brasileiros com áreas das chamadas ciências duras; e) constatamos que na experiência investigada não houveram menções diretas aos impactos econômicos gerados na assimetria da geopolítica do conhecimento entre Norte e Sul global. This dissertation analyzed the racial issue at the National Institute of Science and Technology for the Inclusion of Teaching and Research (INCTI), within the scope of the Encontro de Saberes Project (PES) carried out between 2010 and 2013. Specifically, it was discussed how the establishment of epistemological dialogues between scientific knowledge and the so-called traditional Afro-Brazilian knowledge (s) took place. The provisional hypothesis was that the practices of science and technology, in the investigated context, were crossed by structural racism that has among its expressions epistemic racism, materialized by the erasure, invisibility and silencing of non-Eurocentered knowledge. The central theoretical references of this research are aligned with the epistemological perspectives of the global South, for that, the contributions of Decolonial authors such as Ramón Grosfoguel (2008, 2011, 2020) GROSFOGUEL; Figueiredo; Grosfoguel (2009); Costa, Joaze Bernardino; Grosfoguel, Ramón (2016) and Santos Boaventura (2000, 2008). From the standpoint of methodological instruments, this research had a qualitative approach and was carried out through a bibliographic and documentary survey. In the bibliographical research, the documental survey was carried out on materials available on the website of the Ministry of Science and Technology, the National Scientific and Technological Council ¿ CNPq and the National Institute of Science and Technology for Inclusion in Teaching and Research (INCTI). As a result, this research found, among other aspects, that: a) the constitution of an institute, such as INCTI, focused on science and technology was important politically, epistemologically and methodologically to be able to connect inclusion, science, technologies, teaching and research with race relations; b) there was, in the investigated action, the construction of ST&I practices from counter-hegemonic strategies, that is, as processes built in struggle, oppressed social groups appropriate philosophies and practices, such as laws, international law, etc. , redefining them, reconfiguring them, subverting them and transforming them into tools against domination; c) there was resistance on the part of the scientific community to the creation of an institute dedicated to science, research and teaching, which would link its identity to the ethnic-racial issue; d) the identified practices were not able to break the silence regarding the construction of dialogues between Afro-Brazilian knowledge and areas of the so-called hard sciences; e) nor did they make direct mention of the economic impacts generated by the asymmetry of the geopolitics of knowledge between the global North and South.

Cloud computing is a revolutionary paradigm in relation to its characteristics which can be highlighted the high connectivity, elasticity, assignment of measurable services and ease of management. These attributes favor the promotion of this technology, such as the increasing use of virtualization services in public and private institutions. Therefore, part of the efficiency of this service is based on the allocation of virtual resources that enable different configurations in different applications. In relation to this context, this paper aims to present the allocation module of the Architecture Management of Hybrid Resources in Private cloud Architecture (MoHRiPA), which was modeled with the purpose of providing high performance during the allocation of virtual machines. Its architecture and component specification will be presented, with emphasis on the resource allocation module that has hybrid properties, which makes it possible to support the use of different virtualization tools. The results obtained are described by means of a complete factorial planning with their respective more accurate analyzes about the functionalities and peculiarities of the allocation module.

Every day, numerous solutions focused on the Internet of Things (IoT) are developed to address domains such as environmental monitoring, mobility, and industry 4.0. The size of these ecosystems increases their complexity, and several of these domains have problems such as scalability, energy consumption, low-latency edge applications, multiobjective decision making, fog with cloud interaction, among other features and aspects that are not generally considered when designing a wireless network. The choices made during the design of the network influence its configuration, something that reinforces the importance of using a tool for simulating a wireless sensor network (WSN). Therefore, it is essential to model, analyze the degree of complexity of a network project before its implementation, and develop solutions. Based on this context, we presented a general review of some WSN simulators and the assignment of one of these simulators for the development of a network project for IoT sensors in public transport.

Objective: To assess the functional independence of a group of patients with mucopolysaccharidosis using the Functional Independence Measure as a tool that accomplishes this purpose. Methods: This is a cross-sectional study of patients with mucopolysaccharidosis. Our data was collected between June 2015 and July 2016. In addition to history of present illness and physical examination each study participant was asked to answer a questionnaire to specifically evaluate their functional independence using the functional independence measure. the internal consistency of the functional independence measure was assessed using Cronbach’s alpha coefficient. Results: We collected data on 20 patients with mucopolysaccharidosis. The average age was 10.8 (8.67-13.03) years, the average weight was 23.6 (19.91-27.37) kg and the average height was 1 (0.83-1.17) m. The most prevalent type of mucopolysaccharidosis in the study was type VI (n= 14). The average total functional independence measure score was 104.4 (97.61-111.19), the average for the mobility domain was 73.50 (68.22-78.78) and the average for the cognitive function domain was 30.90 (28.68-33.13). The internal consistency of the entire questionnaire was 0.859, with values of 0.966 for the mobility domain and 0.624 for the cognitive function domain. Conclusion: The lowest functional independence measure scores were obtained in the following sub-domains: self-care, locomotion and cognitive function. The functional independence measure questionnaire demonstrated internal consistency for the evaluation of functional independence in patients with mucopolysaccharidosis, being able to value all the affected sub-domains separately. Resumen Objetivo: Evaluar la independencia funcional de un grupo de pacientes con mucopolisacaridosis utilizando la Medida de Independencia Funcional como herramienta para lograr este propósito. Métodos: Este es un estudio transversal de pacientes con mucopolisacaridosis. Nuestros datos se recopilaron entre junio de 2015 y julio de 2016. Además de la historia de la enfermedad actual y el examen físico, se pidió a cada participante del estudio que respondiera un cuestionario para evaluar específicamente su independencia funcional utilizando la Medida de Independencia Funcional. la consistencia interna de la Medida de Independencia Funcional se evaluó mediante el coeficiente alfa de Cronbach. Resultados: Recopilamos datos de 20 pacientes con mucopolisacaridosis. La edad promedio fue de 10.8 (8.67-13.03) años, el peso promedio fue de 23.6 (19.91-27.37) kg y la altura promedio fue de 1 m (0.83-1.17). El tipo de mucopolisacaridosis más prevalente en el estudio fue el tipo VI (n= 14). El puntaje promedio de la medida de independencia funcional total fue 104.4 (97.61-111.19), el promedio para el dominio de movilidad fue 73.50 (68.22-78.78) y el promedio para el dominio de función cognitiva fue 30.90 (28.68-33.13). La consistencia interna de todo el cuestionario fue de 0.859, con valores de 0.966 para el dominio de movilidad y 0.624 para el dominio de función cognitiva. Conclusión: Las puntuaciones más bajas de la medida de independencia funcional se obtuvieron en los siguientes subdominios: autocuidado, locomoción y función cognitiva. El cuestionario de medida de independencia funcional demostró consistencia interna para la evaluación de la independencia funcional en pacientes con mucopolisacaridosis, pudiendo valorar todos los subdominios afectados por separado.

We evaluated the initial development of watermelon cv. Crimson Sweet seedlings grown in different organic substrates and electrical conductivity of irrigation water. The experiment was carried out in a greenhouse between January and March of 2017. The experimental design was in randomized blocks with factorial arrangement 3 x 5. The treatments were combinations of three substrates: soil + bovine manure (SBM) (1:1); soil + sheep manure (SSM) (1:1) and commercial substrate Basaplant ® (CS), and five electrical conductivity of irrigation water (EC iw ): C1 – 0.3 dS m -1 ; C2 – 1.5 dS m -1 ; C3 – 2.7 dS m -1 ; C4 – 3.9 dS m -1 and C5 – 5.1 dS m -1 . Plant height, number of leaves, stem diameter, root fresh mass, stem fresh mass, leaf fresh mass, root dry mass, stem dry mass, and leaf dry mass were evaluated at 37 days after sowing (DAS). The interaction between substrate x EC iw significantly affected the variables plant height, number of leaves, stem fresh mass and leaf fresh mass; all the analyzed variables were affected by substrate factor, while plant height, number of leaves, root dry mass, stem dry mass, and leaf dry mass were affected by EC iw . It is possible to produce watermelon cv. Crimson Sweet seedlings using water with electrical conductivity up to 2.86 dS m -1 associated with commercial substrate and up to 2.67 dS m -1 associated with sheep manure. It can be inferred that the use of commercial substrate is more suitable for the production of watermelon cv. Crimson Sweet seedlings.

Background. Lower limb fractures are associated with severe disability, prolonged treatment and recovery time, and account for the greatest number of surgical procedures. Studies focusing on the health related quality of life (HRQOL) of patients who sustained lower limb fractures at a productive age are still scarce. The aim of the present study was to assess the HRQOL of individuals who sustained lower limb fractures at two time points: during the acute trauma period (hospitalization) and after six months. Materials and methods. A prospective observational longitudinal study was conducted including a total of 121 patients aged 18 years or older with fractures in the lower limbs evaluated based on clinical and sociodemographic variables and using the HRQOL questionnaire SF-36. The data were collected from referral trauma hospitals in two stages: during hospitalization (in-hospital period) and from the same individuals six months after the first interview. Results. At six months following the trauma, significant differences were found for the domains of functional capacity (from 2.77±7.82 to 51.11±28.43), pain (47.51±35.51 to 74.29±21.63), and emotional impairment (57.01±47.62 to 91.22±22.92) in the study period. However, no improvement was observed in the domains of physical limitations and social aspects. There was significant association for the domain “Pain” with age, level of education, and rehabilitation; the domain “Emotional impairment” was associated with treatment within 10 hours, level of education, and immediate osteosynthesis. At six months, only functional capacity exhibited significant associations with the level of education and rehabilitation. Conclusion. Lower limb fractures have a negative impact on the HRQOL that persists for at least six months after the traumatic event and is reflected in the psychosocial, physical and emotional burden imposed by the trauma.

OBJETIVO: Verificar se existe correlação entre os domínios da qualidade de vida e a funcionalidade nos pacientes com desordens do manguito rotador. MÉTODO: Estudo do tipo transversal com 109 pacientes avaliados entre outubro 2013 e fevereiro 2014. Para avaliar a qualidade de vida foi utilizado o questionário WORC, e as escalas UCLA e ASES para avaliação da funcionalidade. RESULTADO: Amostra de 73 mulheres e 36 homens (média de idade: 52,3 anos+12,8). O ombro avaliado foi o direito em 63 pacientes (57,8%). O WORC apresentou correlação positiva alta com as escalas UCLA (r= 0,73) e ASES (r= 0,77). Ao analisar o WORC verificou-se correlação mais forte com a UCLA no domínio “Trabalho” (r= 0,74), e menor no domínio “Esporte/Recreação” (r= 0,67). Quando comparado o WORC com a ASES identificou-se a maior correlação com o domínio “Trabalho” (r= 0,79) e menor correlação com o domínio “Emoções” (r= 0,64). CONCLUSÃO: Alterações na funcionalidade, frequentes nestas desordens, impactam na qualidade de vida em especial no domínio “Trabalho”.

Delinear a estrutura da representação social das fraturas de membros inferiores em indivíduos hospitalizados. Estudo qualitativo, com sessenta e seis indivíduos internados por acidentes por causas externas e com fratura em membros inferiores há mais de vinte 24 horas. Para as variáveis sociodemográficas e clínicas utilizou-se análise descritiva. O teste projetivo de evocação livre de palavras foi empregado para conhecer as características qualitativas dos elementos centrais e periféricos da representação social. Os elementos centrais foram incapacidade para o trabalho, ter mais cuidado no trânsito e tristeza. Entre os elementos periféricos, dificuldade e dependência financeira. Emergiram evocações pouco debatidas na literatura. A fratura em membros inferiores não confere uma letalidade observável. Porém, reflete negativamente nos aspectos biopsicossociais e qualidade de vida dos indivíduos. Palavras-chaves: Saúde do adulto; hospitalização; causas externas.

Diagnosis of synovitis/tenosynovitis by physical examination can be difficult. Ultrasound (US) can be an effective tool for the evaluation of joint involvement in systemic lupus erythematosus (SLE). This study will describe musculoskeletal findings by US in SLE patients and the evaluation of their correlation with physical examination. SLE patients underwent clinical/sonographic evaluation of hand/wrists. In total, 896 joints were evaluated: at least 1 change on physical examination was found in 136 joints and at least 1 US abnormality was found in 65 of 896 joints. Out of the 65 joints with US changes, only 13 had findings on physical examination. Conversely, 111 joints had tenderness on physical examination with no sonographic abnormalities. Tenosynovitis was statistically significant more frequently with joint edema (41%) (p = 0.0003). US can detect musculoskeletal changes in only a minority of symptomatic SLE patients. Clinical findings may be related to some reasons that cannot be explained using US.

Purpose To analyze the location of the femoral tunnel by three-dimensional computed tomography (3D CT) of the lateral condyle in patients who underwent arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction, performed using a modified transtibial technique, and to compare the results with data from the literature. Materials and methods Seventeen patients with ACL lesions underwent modified transtibial ACL reconstruction. Postoperatively, 3D CT examinations were performed and the images were analyzed by the quadrant system described by Bernard and Hertel to define the femoral tunnel coordinates. Results The mean value of femoral tunnel location coordinates was 37.1±5.9 in the horizontal plane and 23.9±7.5 in the vertical plane. Compared with other studies using the transtibial or transportal technique, femoral positioning was improved in the vertical plane. The outside-in technique provided the best results both in the vertical and horizontal planes. Conclusions The modified transtibial technique was not effective for systematically anatomic femoral tunnel positioning; however, it was relatively better than the conventional transtibial technique.

Transcranial Direct Current Stimulation (tDCS) uses a direct electrical current to modulate the activity of cortical neurons. Anodal tDCS (positive pole) increases the excitability of cortical neurons, while cathodic tDCS (negative pole) reduces it. However, when applied in the peripheral nervous system the effects are the opposite of cranial application. Furthermore, when central and peripheral stimuli are used concomitantly, their effects can be summed up. This has been demonstrated by combining tDCS with other forms of sensory peripheral stimulation. We propose a new electrode configuration to potentiate the excitatory and inhibitory effects of tDCS on neuronal excitability and increase upper limb motor function. Our hypothesis is that placement of the electrodes in the primary motor cortex (M1) and the contralateral brachial plexus (BP) would promote this potentiation by central and peripheral synaptic summation. We will test our hypothesis in two proof-of-concept studies. Study 1) Secondary trial, in which we will evaluate the effects of these configurations on the neuronal excitability of healthy individuals; Study 2) A double-blind, randomized and crossover clinical trial in which we will test the stimulation with the anode in M1 and the cathode in the contralateral BP on the motor function and electrophysiological markers of individuals with cerebral palsy. The effects of the new configurations will be compared with the conventional configuration (M1 / contralateral supraorbital region). We expect that our investigations will identify a more efficient way to apply tDCS and consequently a better clinical use of this technique.

Artigo original: Marcos Almeida Matos, Jandrice Carrasco, Luanne Lisle, Marilda Castelar. Avascular necrosis of the femoral head in sickle cell disease in pediatric patients suffering from hip dysfunction. Rev Salud Pública 2016; 18(6): 986-995.

As mucopolissacaridoses (MPS) formam um grupo de doenças raras de acúmulo lisossomal que se caracterizam pela falta de uma das enzimas responsáveis pela degradação dos mucopolissacarídeos ou glicosaminoglicanos (GAG). Estas doenças têm um importante impacto nas atividades diárias dos pacientes em virtude do comprometimento locomotor, como as mãos. O objetivo deste trabalho foi o de avaliar a mão de pacientes com MPS utilizando a versão brasileira do Michigan Hand Outcome Questionnaire (MHQ). Dos 16 indivíduos selecionados, entre 8 e 21 anos, portadores de MPS, 87.5%, apresentaram MPS IV, sendo as atividades de vida diária o domínio mais acometido com (46.87%). A versão brasileira do MHQ demonstrou ser eficiente, consistente e confiável para avaliação e quantificação do acometimento da mão na MPS. Artigo original: Marcos A. Matos, PhD, Ingrid C. F. Barboza, MD, Marina V. A. R. Ferraz, PhT, and Guy Hembroff, PhDMichigan Hand Outcomes Questionnaire for the Evaluation of Patients with Mucopolysaccharidosis. Bulletin of the Hospital for Joint Diseases 2018;76(2):112-5.

Os profissionais de saude praticam suas atividades diariamente, com ciencia e dedicacao, em diversas situacoes de cuidados excessivamente complexos. Nobres, corajosos e cheios de compaixao, querem cada vez mais salvar pessoas, serem uteis, objetivam melhores resultados na assistencia, enfrentam bravamente longas jornadas de trabalho e horas sem dormir, e sao conhecidos como profissionais que se dedicam constantemente, tanto no trabalho quanto nos estudos. Alem disso, possuem uma forma de trabalhar que requer disposicao fisica e agilidade para avaliar, diagnosticar e [...]

Objective To compare the imaging findings of anatomical alterations using multi-slice computed tomographic arthrography in the evaluation of rotator cuff tears in the shoulder, correlating them with the arthroscopy (the gold standard diagnostic test) findings. Materials and Methods A longitudinal, prospective, comparative study of diagnostic accuracy performed in the period between June 2016 and June 2017 in patients of both sexes, aged between 40 and 70 years, with shoulder rotator cuff tendon tears and therapeutic need to undergo shoulder arthroscopy. Patients with contraindication to magnetic resonance imaging were included. After multi-slice computed tomographic arthrography, all patients underwent arthroscopy. Results To obtain the results, the following parameters were determined: sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Kappa coefficient, and contrast between the imaging method and arthroscopy. Conclusion In the impossibility of performing magnetic resonance imaging (the gold standard imaging technique), multi-slice computed tomographic arthrography is an imaging examination capable of evaluating/diagnosing rotator cuff tears. Resumo Objetivo Comparar os achados por imagem das alterações anatômicas da artrotomografia computadorizada multi-slice na avaliação das lesões do manguito rotador do ombro e correlacioná-los com os achados da artroscopia (exame diagnóstico padrão-ouro). Materiais e Métodos Estudo longitudinal, prospectivo, comparativo de acurácia diagnóstica, feito de junho de 2016 a junho de 2017, em pacientes de ambos os sexos, com idades entre 40 e 70 anos, com lesão dos tendões do manguito rotador do ombro, e que tinham necessidade terapêutica de fazer artroscopia do ombro. Foram incluídos pacientes com contraindicação à realização de ressonância magnética. Após a artrotomografia computadorizada multi-slice, todos os pacientes foram submetidos a artroscopia. Resultados Para a obtenção dos resultados, os seguintes parâmetros foram considerados: sensibilidade, especificidade, acurácia, valor preditivo positivo, valor preditivo negativo, coeficiente Kappa, e contraposição do método de imagem com a artroscopia. Conclusão Na impossibilidade da realização da ressonância magnética (exame de imagem padrão-ouro), a artrotomografia computadorizada multi-slice se mostra um exame de imagem capaz de avaliar/diagnosticar as lesões do manguito rotador.

To measure the functional independence to perform activities of daily living of pediatric patients diagnosed with mucopolysaccharidoses.A descriptive cross-sectional study was carried out with the population of pediatric patients with a confirmed enzymatic diagnosis of mucopolysaccharidoses, enrolled in the Orthopedics outpatient clinic of a hospital in the State of Bahia. The data were collected between October 2016 and March 2017, based on the documentary analysis of the assessment forms used in the department. The variables of this study comprised sex, age, type of MPS and level of functional independence, measured by the Functional Independence Measure scale.Twenty-six patients participated in the study. These were predominantly male (61.5%), with a mean age of 10 ± 4.5 years, affected by MPS VI (73.1%). In the motor domain, the mean score was 65 (± 19.9 points); the cognitive domain obtained a mean score equal to 28 (± 8.2 points); and the total FIM score was 93 (± 26.5).Impaired functional independence was observed among children and adolescents with mucopolysaccharidoses. Tasks related to dressing, toileting, bathing, problem solving and social interaction were those that required the most assistance and/or supervision.Medir a independência funcional para realização de Atividades de Vida Diária de pacientes pediátricos diagnosticados com mucopolissacaridoses (MPS).Estudo transversal, descritivo, realizado com a população de pacientes pediátricos com diagnóstico enzimático confirmado de mucopolissacaridoses, cadastrados no ambulatório de ortopedia de um hospital no Estado da Bahia. Os dados foram coletados entre outubro de 2016 e março de 2017, a partir da análise documental das fichas de avaliação utilizadas no serviço. As variáveis deste estudo compreenderam sexo, idade, tipo de MPS e nível de independência funcional, mensurado pela escala de Medida de Independência Funcional.Participaram do estudo 26 pacientes, que eram predominantemente do sexo masculino (61,5%), com média de idade de 10 ± 4,5 anos, acometidos por mucopolissacaridoses VI (73,1%). No domínio motor, a pontuação média foi 65 (± 19,9 pontos); o domínio cognitivo obteve escore médio igual a 28 (± 8,2 pontos); e o escore total da MIF foi 93 (±26,5).Foi observado comprometimento da independência funcional de crianças e adolescentes com mucopolissacaridoses. Tarefas relacionadas ao vestuário, utilização do vaso sanitário, banho, resolução de problemas e interação social foram as que demandaram maior assistência e/ou supervisão.

Background The aim of the present study was to evaluate health-related quality of life in pediatric patients with avascular necrosis of the femoral head. Material and methods A comparative study was conducted involving 32 children and adolescents in "ONFH Group" (subjects with a diagnosis of ONFH) and 44 in "Comparison Group" (asymptomatic children), both aged between 8 and 18. Clinical and sociodemographic data were obtained along with PedsQL 4.0 questionnaires to evaluate the quality of life in the age-ranges studied. Results The two groups were similar as regards sociodemographic characteristics. Comparison of the quality of life total scores demonstrated significant differences between the ONFH group and the comparison group (58.86±16.54 versus 82.08±9.51), and this also occurred in all the domains analyzed. The predictors that showed correlation with the quality of life were: presence of necrosis, age, time of diagnosis, radiographic classification, Charnley score, educational level, previous surgeries, and previous infections. Conclusion Our data confirm the hypothesis that pediatric patients with ONFH demonstrate a lower quality of life than healthy children in all the domains evaluated, especially with regard to the physical aspect.

Purpose To verify the association between functional independence (FI) and quality of life (QOL) in patients with knee osteoarthritis. Materials and Methods A cross-sectional study composed of 93 patients with knee osteoarthritis was performed. Osteoarthritis was stratified according the classification of Ahlbach. For evaluation of the patient's overall FI, the Barthel index was used. The patient's QOL was measured by means of the Medical Outcomes Study 36–Item Short Form Health Survey (SF-36) questionnaire. Results The mean age of the patients was 60 years (range, 54.0 to 69.5 years) and only 32 patients (34.3%) were found to be independent. Dependent or independent individuals presented difference in all domains of the QOL including physical function (p=0.001), role-physical (p=0.005), bodily pain (p=0.001), general health (p=0.004), vitality (p=0.009), social function (p=0.010), role-emotional (p=0.002) and mental health (p=0.001). Correlation between FI and QOL was different for all domains of the SF-36. Correlation with FI was strongest for physical function (r=0.609, p

Introdução: A pandemia do COVID-19, ocasionada pelo SARS-CoV-2, provoca desde infecções assintomáticas até a síndrome respiratória aguda grave, que por vezes, pode ser fatal, necessitando de enfrentamento. Objetivo: Analisar a epidemiologia da COVID-19 nas seis mesorregiões do estado do Pará, correlacionando-a com Índice de Desenvolvimento Humano Médio (IDHm) e o Percentual de Tratamento de esgoto do Estado. Métodos: Trata-se de um estudo descritivo transversal com abordagem quantitativa, realizado através do levantamento de dados secundários dos casos de COVID-19, coletados no período de 07 de março a 30 de maio de 2020, e dados sócio-demográficos das seis mesorregiões do estado do Pará. Resultados: Foram notificados 267.700 casos confirmados da COVID-19 em todo o estado do Pará. As mesorregiões do Sudeste paraense e da Região Metropolitana de Belém, apresentaram os maiores valores, com 81.556 e 71.117, respectivamente. Não houve diferença de número de casos entre os gêneros, porém as duas faixas etárias mais acometidas pela infecção estão entre 30 a 39 anos (64.138 casos) e 40 a 49 anos (51.535 casos). Dentre as comorbidades mais prevalentes estão as Cardiopatias e o Diabetes. Conclusão: As maiores taxas de incidência da COVID-19 estão concentradas nas mesorregiões com grande fluxo de pessoas, havendo uma tendência dos aspectos sociodemográficos se relacionarem com a epidemiologia da COVID-19 nas mesorregiões do estado do Pará.

Ao longo do tempo, a pesquisa científica tem sido a base para o exercício profissional na área de saúde. Metodologias sistematizadas, guidelines baseados em artigos científicos, medicina baseada em evidência e outras iniciativas sedimentaram a medicina tecnológica, cujas práticas centradas no conhecimento técnico-científico ainda são o modelo prevalente nos dias atuais.

23 páginas